Squamous cell carcinomas of the mandibular alveolus: Analysis of prognostic factors
Squamous cell carcinomas of the mandibular alveolus: Analysis of prognostic factors
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DOI：
10.1159/000048242
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发表时间：
2002-01-01
期刊：
影响因子：
3.5
通讯作者：
Nakajima, T
中科院分区：
文献类型：
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作者：
Shingaki, S;Nomura, T;Nakajima, T
背景：探讨临床病理因素对下颌牙槽癌局部肿瘤控制及生存的影响。方法：对50例经手术治疗的下颌牙槽癌患者进行研究。T1 3例，T2 25例，T3 5例，T4 17例。47例患者出现骨侵犯的临床证据。37例患者行半或节段下颌骨切除术，10例患者行边缘下颌骨切除术。通过单因素分析评估临床病理变量对局部肿瘤控制和患者生存的影响。变量包括T和N期、拔牙、治疗方式、肿瘤分化、淋巴结状态、手术切缘和骨侵犯。结果：11例（22%）复发，其中8例局部复发，1例颈部，2例远处转移。总体而言，局部控制和疾病特异性生存率的5年精算率分别为85%和73%。大多数手术后局部复发是由于切除边缘不充分引起的。切缘阴性时，生存率和局部控制率明显优于切缘阳性时（生存率91比11%；局部控制率100比49%；p < 0.01）。T和N分期、临床分期、肿瘤分化、拔牙、骨侵犯、骨切除程度和治疗方式均不影响预后。结论：手术切缘的状态对下颌骨龈癌患者的预后有重要影响。版权所有(C) 2002 S. Karger AG，巴塞尔。
Background: To assess the effect of clinicopathologic factors on local tumor control and survival in patients with mandibular alveolar carcinoma. Methods: Fifty patients with mandibular alveolar carcinoma treated surgically were included in this study. There were 3 patients with T1, 25 with T2, 5 with T3, and 17 with T4 disease. Clinical evidence of bone invasion was noted in 47 patients. A hemi- or segmental mandibulectomy was performed on 37 patients, whereas 10 patients had a marginal mandibulectomy. The impact of clinicopathologic variables on local tumor control and patient survival was assessed by univariate analysis. Variables included T and N stage, dental extraction, treatment modality, tumor differentiation, nodal status, surgical margin, and bone invasion. Results: Eleven patients (22%) develop recurrent disease, including 8 local recurrences, 1 neck, and 2 distant metastases. Overall, the 5-year actuarial rates of local control and disease-specific survival were 85 and 73%, respectively. Most local recurrences after surgical treatment were caused by inadequate resection margins. When resection margins were negative, the survival and local control rate were significantly better than when there were positive resection margins (survival, 91 vs. 11%; local control, 100 vs. 49%; p < 0.01). Neither T and N stages, clinical stage, tumor differentiation, dental extraction, bone invasion, extent of bone resection, nor treatment modality influenced outcome. Conclusions: The status of surgical margins was of major importance for the outcome of patients with gingival carcinoma of the mandible. Copyright (C) 2002 S. Karger AG, Basel.